Hoping for some advice. Let me know if this is beyond the scope of a traditional QA and if some other service is needed - I haven’t posted here before.
I have or had Type 2 diabetes.
- I’m 48 years old, 5’10", 180lbs, 17%ish body fat, and my current 5RMs are about 225 Squat, 300 Dead, 170 Bench, and 110 OHP.
- In 2018, I lost 70lbs and started lifting weights without an LP. Blood sugar, cholesterol, A1c all went down to normal ranges. My PCP took me off Metformin and cut my Atorvastatin down to 10mg/day.
- In January, I ramped up my diet from about 1800cal/day to about 3300cal/day and started LP, gaining about 1lb/week.
- I’m at the tail end of LP now (advanced novice - some light days). Yes, I know my lifts are low for end of LP - I’m not very genetically gifted for this and have nagging technique issues I can’t fix.
On LP, my blood sugar started going up. My daily morning/fasting blood sugar went from about 96 without metformin, and slowly crept up, now averaging about 118. I’ve cut back on carbs a bit as a result, down to <300g/day, and a lot of protein (more than necessary - need the calories). That seems to help a little - days where I eat more carbs, I have higher blood sugar the next morning. I’ve actually tracked this and run a linear regression, and I think my blood sugar might be normal if I went down to 100g/day, but I would be completely miserable and not eating enough fruits/veggies - probably not a good idea.
Then I saw my doctor/PCP, expecting him to put me back on Metformin. But, strangely, my a1c was fantastic! 4.6%, or an average blood sugar of 86. I knew that had to be wrong - I’ve hadn’t recently ever measured it below 90. My PCP believed the a1c number and didn’t prescribe metformin, and my morning blood sugar is still rising slowly. Other relevant data points:
- My eye doctor noted diabetes-related damage in my retina.
- My triglycerides also went down similarly to my a1c, which led my PCP to believe the a1c was right and my glucometer was wrong.
I’m not sure what to do here - I’ve tested my glucometer with test solution and tried a different brand, each showing consistent results. My thought is that I probably need to either go on a Keto diet, or get Metformin. I don’t like either of those, but I have to deal with reality. I’ve tried adding a garlic supplement with no noticeable effect, and am considering chromium.
If you want to see my pathetic lifts (they aren’t exciting), I’m on instagram as not.that.adam.levine.
–>Adam
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Why did you choose to ramp your calories and weight gain back up?
What is your waist circumference at the moment?
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Austin,
First, thank you for responding. Any help is appreciated, and I’m unsure what to do.
My waist circumference is 34.5", and didn’t really move much while gaining 8lb on LP. If it’s relevant, LP is now over. My current plan is to continue gaining until I hit 19-20%ish body fat, then diet again and oscillate between 15-20%-ish.
As for starting to gain weight - that was my plan for LP. When I started dieting, I was shooting for about 19%BF. Then I learned about SS and that I needed to gain weight if I started an LP. My non-textbook solution to that was not to start LP and finish my diet first, actually going lower than I had originally planned so I would have room to gain on LP. I know that’s not the preferred strategy, but that’s what I did.
I also may have figured out the cause of the a1c vs. fasting glucose variation. I donated double RBCs a month before the a1c test (blood centers love my rare antigen). I may have had more “new” RBCs than the test expects.
–>Adam
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I see.
What are your current macros?
Additionally, just to be clear:
Then I learned about SS and that I needed to gain weight if I started an LP.
This is not accurate.
And you are probably correct regarding the A1c variation. Anything that alters the “lifespan” of RBCs (either shortening or lengthening) can influence that test.
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Macros have around 350-380 protein/day, 300-340 carbs, and 80-95 fat for the past few weeks. Most of the sub-numbers related to diabetes numbers are good - 80-100g fiber and very little refined sugar, with most of my sugar is coming from fruit. These are actuals, not targets. Earlier in LP, carbs were lower and protein was higher.
I understand the weight needs of LP better now - but that was my understanding at my first read of SS, where Rip says that gaining strength is much harder than losing weight, so gain strength first. That didn’t make sense to me - I wanted to do the easy thing first. He is, of course, right, learning technique and getting stronger is way harder than losing weight. Now at 17%bf and age 48, I think a little weight gain is appropriate for me, if I’m wrong, I’m definitely listening.
–>Adam
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If this is true, I am very impressed that you are able to put away 380 g of protein and 100 g of fiber per day. With that said, I would probably not recommend that someone with a history of type 2 diabetes and diabetic retinopathy suddenly increase their calorie intake by 1500 kcal/day in order to gain weight at that pace in conjunction with a low volume training program (i.e., the novice LP, and presumably without any conditioning).
Insulin resistance tends to occur in the context of cellular energy overload (and a few other situations), and you are seeing evidence that the modest gains you are seeing from this approach are probably not worth the risk to your health.
Austin,
Thank you very much - this has been immensely helpful. I went back and looked at my historical data in MyFitnessPal. What you are saying matches pretty well with my data. Before LP, I was doing intervals, chins, and on a diet of about 2200-2400 calories. Fasting blood sugar was normal (96ish, without Metformin).
As I slowly ramped up the diet on LP (I was trying to gain weight, slowly adding calories), the blood sugar moved pretty much lock-step with that.
So, the obvious dietary solution is to go back down to 2200-2400 calories, which for me is near maintenance, maybe a very slow weight gain. I’m good with that.
The next question is programming - strategies in PP of trying to add 5lb to the bar every week may not work on this diet - I think they need a bigger calorie surplus. I don’t know my 1RM and am terrible about knowing RPE - when I fail, I’m surprised, and when I succeed, I’m surprised - I have no sense of “reps in the tank”. I should still be able to get stronger on this diet, just not as quickly. I’m good with that as well.
–>Adam
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What are your goals? Why do you train?
It is my understanding that you are working with a coach. What do they think about this situation?
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Main goals are twofold. First, general health. Secondly, I have a special needs child who is becoming a teenager - I need to be strong enough that he can’t just shove me around when puberty hits and he gets bigger. There are times that I do have to restrain him physically, and he’s already stronger than my wife, which is getting problematic. I have no dreams of being a competitive powerlifter - you don’t take up a sport at age 47 and expect not to suck.
I’m seeing SSC Mia Inman once a month and have club-level SSOC, but I’m going to be dropping SSOC soon.
I’m thinking that the SS model may be overkill for my needs. Lift the NASM way - lift, and when it feels like you can add weight, add weight. Add some intervals, and maybe take some of those cardio-boxing classes at my gym.
–>Adam
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I would still recommend you squat, press, and deadlift, but agree that a change in the diet & programming approach is in order given your stated goals and medical conditions.
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Just wanted to thank you and report back - your advice was appreciated, helpful, and is working.
The new diet has brought down my blood sugar considerably - from an average of about 120 to 112 fasting, and hopefully, there is more benefit to be had if I stick to it. I lost a little weight on it at first, but that stabilized, and now it looks like it’s near maintenance.
I’m also going to start a new training program after my SSOC contract ends 4/27. I’m leaning toward one of Andy Baker’s templates that rotates low and high volume, so I can measure the effect volume has on blood sugar. Also adding conditioning, probably some kind of HIIT or cardio-boxing classes.
–>Adam